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Submitted by on Jan 28, 2020

Doctors should not only focus on hyperacidity, when evaluating stomach upset.

New developments in research have changed the way gastric pain is diagnosed. Doctors need to examine not only the possibility of excess acidity but also how healthy the patient’s gastrointestinal tract is.

Doctors need to consider these possibilities. Is your stomach upset due to excessive acid or impaired esophagus, stomach, or small intestine motility? Is there a malfunction in the way food is stored, processed, and moved along the digestive tract?

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So the next time you see a doctor who complains of stomach pain that can’t be treated with simple medicine, check for any motility problems that may indicate other abnormalities in the digestive tract.

In the absence of dyspepsia or gastric distress, especially the underlying illness, symptoms such as ulcers can easily suggest hyperacidity. But this is not always the case.

Dr. Olaf Nyren, a university hospital in Uppsala, Sweden, who is one of a group of experts who have thoroughly studied dyspepsia, shows that functional cases (cases without underlying disease) have ulcer-like symptoms maybe these are excessive secretions of gastric juice.

The truth is that only a handful of patients with functional dyspepsia actually have hypersecretion (high gastric acid output). The majority have normal secretions.

The idea that functional dyspepsia differs from that caused by too much stomach acid has been proven by Nyren in two ways.

He did this by showing that factors other than stomach acid were responsible for functional dyspepsia pain. In fact, the more severe the problem of functional dyspepsia, the lower the acid output. Therefore, reducing acid secretion is not always effective in alleviating the condition.

With this in mind, patients complaining of gastric upset should not always be treated for hyperacidity. However, disappointing Nyren, many doctors, especially general practitioners, are not aware of this, and patients are still being treated with acid-reducing drugs.

Another maldigestion expert, Dr. JR Malagelada of the Mayo Clinic, added that about 50% of patients with functional dyspepsia have some type of movement disorder-the most common being the antral region of the stomach. It is a decrease in gastric emptying caused by slow contractions of the stomach and also increased resistance to food flow into the small intestine.

Gastrointestinal dysmotility studies do not completely tell the cause of symptoms of dyspepsia but have helped to divert attention from abnormal gastric secretions and organic lesions as the main cause of stomach upset.

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